Covid Exposure Reporting Form
If you have recently been exposed to or tested positive for Covid-19 please submit this form. Your identity will be kept confidential from other students and instructors. This will allow us to notify other students of a potential covid exposure along with the county health department.
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Name
Email Address
What class are you currently enrolled in at DTCCC?
Date of exposure/test/first symptoms?
MM
/
DD
/
YYYY
Please do not attend any other classes at the club for 14 days. If you would like to share any other information please let us know here. Thank you for helping us keep the everyone safe!
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